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Health (Pricing and Supply of Medical Goods) Bill 2012 [Seanad]: Second Stage (Resumed) (Continued)

Monday, 17 December 2012

Dáil Éireann Debate
Vol. 787 No. 2

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  12 o’clock

(Speaker Continuing)

[Deputy Anthony Lawlor: Information on Anthony Lawlor Zoom on Anthony Lawlor] I commend the Minister on his successful negotiations with the pharmaceutical industry, the medical profession and the pharmacists. Currently, we are spending €1,900 million per annum on drugs and we hope to save approximately €135 million per annum over the next three years. This is very welcome.

We need to explain to the public exactly what is meant by generic drugs. The vast majority of people who will avail of this new system might not know what is meant by a generic drug. It is important that we communicate this information. The interchangeable list will be key. If an elderly person who has been used to a drug for a long period is told they can now use a new drug, it must be clearly explained that the new prescription is not for a different drug but for the same drug under a different name. For example, Ventolin and Airomir are both used in the treatment of asthma but they have the same active ingredient, which is salbutamol. When people know the key part of two drugs is the same, irrespective of the name of the drug, they will understand the system better.

The saving made by the new system is a key factor, but we must also be aware of the fear factor. A customer may be concerned if a pharmacist offers an alternative drug and may be worried that the drug being offered does not have the proper active ingredient or the correct percentage of the active ingredient. While the Bill, and the savings it will make, are welcome there must be a huge communication programme so people, particularly elderly people, are not confused when they are offered an alternative drug. Doctors must be involved in explaining this to patients. They have the trust of their patients. The involvement of doctors will make the scheme easier and more understandable.

The Minister can review the list regularly every three years or more often. This is important. New drugs are coming onto the market all the time. A new drug may be an improvement on an existing drug but may be more expensive because it is still under patent. We need to be able to put these new drugs, which will improve the health of patients, on the list more quickly than at present. I realise that will mean an additional cost, but if we can save money on one side we should use that saving to make improved drugs available more quickly.

I reiterate what Deputy Regina Doherty said about anti-epilepsy drugs. With other Deputies, I attended a talk given by Brainwave, the Irish epilepsy association. Minute changes in generic drugs can have a serious implication for people on long-term anti-epilepsy drugs. It is important that we take the fears of the association into consideration.

I welcome the hard work done by the Minister and his Department on the Bill. This is something we should have done a long time ago. There was a fear that if we did something like this the pharmaceutical companies would shut up shop and leave. Most of us understand that the major pharmaceutical companies are here largely because we have a low rate of corporation tax, a highly skilled workforce and a readily available natural resource. For those reasons, we should not fear the use of generic drugs.

I welcome the hard work done in preparing the Bill. The health service will get better value for money and we may be able to use the money saved in other areas in the future.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath I thank you, a Leas-Cheann Comhairle, for the opportunity to speak on the Health (Pricing and Supply of Medical Goods) Bill 2012. This is an important Bill and it is also important to develop the debate on drugs, their cost and the efficient running of our health services. Because of the downturn in the economy the cost of drugs is now a huge issue, but efficiency and the cost of drugs to our health service should always have been an issue.

  In dealing with the issue of pricing, we also need to ensure the safety of drugs. Safety must never be at issue in the supply of drugs, particularly by multinational companies.

  This debate also gives us an opportunity to look closely at multinational drugs companies and their role in Irish society. They are an important aspect of the broader debate and of the debate on the Bill.

  The pricing of drugs has emerged as a huge issue, but we must maintain a balance and consider the broader view of community life and the safety of patients. Recently, I was asked by a drugs company in the United Kingdom to lobby the Government regarding a new drug that will have a major impact on cystic fibrosis patients. I have gone to the Minister, made the details known to him and recommended the drug, which might have a major impact on 160 cystic fibrosis patients. The company claims this is a radical new drug that could save lives, and the Minister and the HSE appear to be open to this idea.

  Sadly, the drug has a very high cost, but what is the cost of a human life? To supply the drug to a cystic fibrosis patient could cost between €200,000 and €400,000 per year, but it has huge potential to save the lives of these people. I have given the information and the name of the company to the Minister and to the HSE. I ask the Minister of State to look at the proposals regarding this new drug that has just been invented. It could have huge potential. We can deal with its cost at a later date. If it can save human lives we should get on with it. This issue also has important implications for the Bill.

  The main objectives of the Bill are to promote competition between suppliers of interchangeable medicines and ensure value for money in the supply of medicines or other prescribed items to patients under section 59 of the Health Act 1970. The Bill will enable patients to opt for lower cost interchangeable generic medicines, establish a list of prescribed items that may be supplied or reimbursed by the HSE to patients under the GMS scheme and community drugs schemes, and establish mechanisms for setting the prices of these items where they are so supplied. No cost to the Exchequer will arise from the Bill and the introduction of generic substitution and reference pricing has the potential to deliver significant savings for the State over the medium to long term.

  Cost saving is positive and sensible and we need to look seriously at it. We must also be careful to get the balance right. The pharmaceutical sector is a major employer in Ireland. A number of my colleagues referred to corporation tax. Yesterday in The Sunday Business Post I read an interview with David Gallagher, managing director of Pfizer Ireland.

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